JULY 20, 2023, NEW YORK– Colorectal cancer that metastasizes to the liver can be challenging to treat. But some patients with limited metastasis can achieve long-term survival, or even be cured, if they receive aggressive localized interventions, such as surgery or radiation therapy. Such interventions only result in long-term survival for about 20-30% of patients. Who those patients might be, however, has remained an open question.
Researchers led by Ludwig Chicago’s Sean Pitroda have now found an answer of sorts. They have developed a method to accurately predict which patients with metastatic colorectal cancer are likely to have a favorable outcome following surgical removal of liver metastases, an achievement that could help improve the personalization of colorectal cancer therapy.
The study, published in the current issue of JAMA Oncology, builds on previous research led by Pitroda and Ralph Weichselbaum, co-director of Ludwig Chicago, who in 2018 reported unique molecular patterns that identified patients with a favorable subtype of colorectal liver metastases who experienced long survival rates after surgery. Both that and the new study were broadly based on a hypothesis proposed in 1995 by Weichselbaum and Samuel Hellman—a former board member of the Ludwig Institute for Cancer Research—that cancer metastases exist on a continuum, and that those that are relatively limited could be cured with localized treatment.
In the new study, Pitroda and his colleagues collected molecular data from 93 metastatic colorectal cancer patients and derived an artificial intelligence neural network classifier that predicted the molecular subtype of the disease with 96% accuracy. They then validated this classifier on a cohort of 147 patients with limited liver metastases who were treated with chemotherapy and surgery in a clinical trial in the U.K. Their classification, combined with clinical features like tumor size, strongly predicted treatment outcomes in patients.
“Although we have conducted these studies in colorectal cancer metastasis, a similar approach could be applied to other types of cancer,” said Pitroda, who is also an associate professor of radiation and cellular oncology at the University of Chicago Medicine. “We believe this will challenge the way we currently treat metastatic disease and open new opportunities to design future clinical trials and improve outcomes for our patients.”
This summary is derived from a press release prepared by University of Chicago that can be accessed here.